title: Lost productivity and burden of illness in cancer survivors with and without other chronic conditions.
abstract: BACKGROUND
  Cancer survivors may experience long-term and late effects from treatment that adversely affect health and limit functioning. Few studies examine lost productivity and disease burden in cancer survivors compared with individuals who have other chronic conditions or by cancer type.
  
  
  METHODS
  We identified 4960 cancer survivors and 64,431 other individuals from the 2008-2010 Medical Expenditure Panel Survey and compared multiple measures of disease burden, including health status and lost productivity, between conditions and by cancer site for cancer survivors. All analyses controlled for the effects of age, sex, race/ethnicity, and number of comorbid conditions.
  
  
  RESULTS
  Overall, in adjusted analyses in multiple models, cancer survivors with another chronic disease (heart disease or diabetes) experienced higher levels of burden compared with individuals with a history of cancer only, chronic disease only, and neither cancer, heart disease, nor diabetes across multiple measures (P < .05). Among cancer survivors, individuals with short survival cancers and multiple cancers consistently had the highest levels of burden across multiple measures (P < .0001).
  
  
  CONCLUSIONS
  Cancer survivors who have another chronic disease experience more limitations and higher levels of burden across multiple measures. Limitations are particularly severe in cancer survivors with short survival cancer and multiple cancers.
authors.affiliation: Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Emily C
authors.initials: EC
authors.lastname: Dowling
authors.forename: Neetu
authors.initials: N
authors.lastname: Chawla
authors.forename: Laura P
authors.initials: LP
authors.lastname: Forsythe
authors.forename: Janet
authors.initials: J
authors.lastname: de Moor
authors.forename: Timothy
authors.initials: T
authors.lastname: McNeel
authors.forename: Heather M
authors.initials: HM
authors.lastname: Rozjabek
authors.forename: Donatus U
authors.initials: DU
authors.lastname: Ekwueme
authors.forename: K Robin
authors.initials: KR
authors.lastname: Yabroff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000191:economics* / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D011788:Quality of Life; D017741:Survivors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: MEPS; cancer survivors; chronic conditions; comorbidities; quality of life